The Measurement of pH
Basic foundations of acid-base chemistry for the intensivist
The Arrhenius definition of acids and bases
The Brønsted-Lowry definition of acids and bases
Lewis' definition, and the modern concept of acids and bases
The hydrogen ion as a convenient narrative device
The Sorensen definition of pH as hydrogen ion concentration
The modern concept of pH
The gold standard of pH measurement
History of the glass electrode
Measurement of pH in a modern ABG analyser
Neutrality and the influence of temperature and pressure on pH
Alpha-stat and pH-stat models of blood gas interpretation
Respiratory Contribution to Acid-base Balance
Buffering in acute respiratory acid-base disturbances
Assessment of compensation in acute respiratory acidosis
Metabolic Contribution to Acid-base Balance
Mechanisms and classification of metabolic acidosis
Classification and diagnostic approach to metabolic alkalosis
Normal Anion Gap Metabolic Acidosis
The strong ion difference in normal anion gap acidosis
Normal saline intoxication
Uncontrolled pancreatic secretions as a cause of acidosis
High output small bowel fistula as a cause of acidosis
Diarrhoea as a cause of normal anion gap acidosis
Ureteric diversion as a cause of normal anion gap acidosis
Hyperalimentation acidosis associated with TPN
Type 2 renal tubular acidosis and acetazolamide
Type 1 (distal) renal tubular acidosis
Type 4 (hyperkalemic) renal tubular acidosis
The urinary anion gap in normal anion gap metabolic acidosis
Assessment of Acid-Base Disturbance and Buffering
The actual bicarbonate value
The standard bicarbonate value
The actual base excess
Standard base excess
Assessment of compensation: Boston and Copenhagen methods
Stewart's approach to analysis of acid-base disorders
High Anion Gap Metabolic Acidosis
Methanol and the other toxic alcohols
'Uraemic' acidosis: the mixed acidosis of renal failure
Sulfate anion: its origins and its clearance
Phosphate anion: its origins and its clearance
Urate and hippurate anions: their origins and clearance
Ethylene glycol and its toxic acid metabolytes
Diabetic, alcoholic and starvation ketoacidosis
Pyroglutamic acidosis
Salicylate overdose
Iron overdose
Practical Interpretation of Blood Gas Data
The officical diagnostic sequence for blood gas interpretation
A systematic approach to the interpretation of blood gas data
Summary of equations used for blood gas interpretation
Delta gap and delta ratio
Physiology of Lactate
Classification systems of lactic acidosis
Metabolic origins and metabolic fate of lactate
Causes of acidosis in hyperlactataemia
Lactic Acidosis due to Tissue Hypoxia (Type A)
Lactate in circulatory failure and regional ischaemia
Lactic acidosis due to severe hypoxia
Lactic acidosis due to severe anaemia
Lactic acidosis due to carbon monoxide poisoning
Lactic Acidosis due to Disease States (Type B-1)
Lactic acidosis in sepsis and septic shock
Increased lactate production in malignancy
Thiamine deficiency as a cause of lactic acidosis
Lactic acidosis associated with ketoacidosis
Lactate accumulation in hepatic or renal failure
Lactic Acidosis due to Drugs (Type B-2)
Mitochondrial toxicity due to antiretroviral therapy (NRTIs)
Metformin toxicity and lactic acidosis
Isoniazid overdose associated with lactic acidosis
Cyanide and nitroprusside toxicity
Unregulated xylitol, sorbitol or fructose metabolism
Propofol infusion syndrome
Toxic alcohols as metabolic substrates favour lactate production
Paracetamol causes mitochondrial toxicity in massive overdose
Salicylates interfere with oxidative phosphorylation enzymes
Lactic Acidosis due to Inherited Errors of Metabolism (Type B-3)
The spectrum of inherited defects of lactate metabolism